Okay to opt out of free lunches? (drug reps)

TraceyMarino · Jan 5, 2013

I'm a new NP in a small clinic. We get free lunch from drug reps several times per week. I would prefer not to partake in these lunches for several reasons:
- I have ethical concerns about the free lunches from drug reps
- The food is rarely anything I owuld consider healthy. Plus, I prefer not to eat a big lunch anyway, since it makes me sleepy in the afternoon.
- Lunch really doesn't feel like a break to me if I have to spend it talking to a drug rep. I prefer spending the time quietly in my office, going for a walk, or running an errand. When I stay in the office during lunch-free days, I usually catch up on reading professional journals etc. - much more unbiased eduation than what I can expect from the drug reps.
I'm not sure how it would be received if I just wouldn't show up for the lunches. I feel like it might somehow be expected for me to show up. I'd love to hear from other NPs who have individually opted out of free lunches at their clinic, and whether anyone has questioned them about it.

Hi! I am a new FNP as well, and I was also a pharmaceutical rep for Pfizer for 8 years before going back to clinical practice. I decided I would rather wipe ass than kiss it. Just graduated with FNP, and I am working in a very busy convenient care clinic and family practice group.

I see this issue from both sides. As a clinician, and as a former pharmaceutical rep. No one will fault you for not going to the lunches. When I was a rep, I knew lots of providers who dodged "drug rep" lunches for the very reasons you cite-ethical issues, wanting their lunch break for quiet time or exercise, what ever. A good rep will not be offended or hound you for not attending. and, in reality, many of these lunches provide little value to the provider.

That being said, do not think all reps are bad, unethical, or, that the lunch and learn will be a waste. I attended a recent lunch and learn with the Eli Lilly rep about the new diabetes meds, and it was a great teleconference-the speaker was an NP who works at the Cleveland clinic in endocrinology. In addition to the presentation, I had time to ask questions of this NP expert, who provided great advice and resources for managing patients with complex diabetes with comorbidities. I am very glad I attended this lunch. The rep is also very well versed in reimbursement issues with the new medication, and provided the important info on how to get this medication paid for, or to get free medication for those with no insurance.

Also, FYI--the doctors in your clinic may expect you to attend in their place. When I was a rep, doing a lunch, often my only attendees were the office staff, and the NP's and PA's. The doctors understand that some providers should attend these lunches to "not be rude" and risk the loss of lots of samples from the reps, so they want to give the impression that the office is "rep friendly". So, they may expect this duty to fall on you as the "midlevel". And truly, reps will avoid offices that do not reciprocate with a bit of common courtesy, ie attendance at lunch programs. If other providers are attending, I would not worry about your lack of attendance. Lastly, please realize that reps are human too, and it is a difficult job with a lot of rejection and crappy treatment from providers, staff, and their own district manager, who expects them to do a certain amount of lunch programs. If you do not want to attend their lunches, at least be civil, smile, say hi, sign for samples, then move on. While I disagree on many levels with how pharmaceutical companies operate, esp. with an insider view, they are helpful on several levels.

amulam · Jan 5, 2013

Thank you for your insights, TraceyMarino. I don't think all drug reps are evil, and I have no problem being polite to them, or even briefly listening to what they have to say about their drug. Having to sit down to lunch and do small talk with them during my break is what I have a hard time with on many levels. The MD at my clinic doesn't seem to mind attending the lunches, and I think the other NP is also going most of the time. Maybe I'll just start skipping more and more lunches here and there and see what happens. I guess I just don't want my employer to interpret it as being rude or antisocial somehow or lacking interest in education (nothing could be further from the truth, which is why I otherwise spend much of my lunch time reading professional articles).

nursetim, NP · Jan 5, 2013

I've found the info from detail people, while slanted, beneficial to my practice. No you don't have to eat the food they provide. I have never seen an ethical issue here. I am free to prescribe whatever medication will benefit my patient the most. I also miss the trinkets they used to give out.

Psychcns · Jan 5, 2013

I've found the info from detail people while slanted, beneficial to my practice. No you don't have to eat the food they provide. I have never seen an ethical issue here. I am free to prescribe whatever medication will benefit my patient the most. I also miss the trinkets they used to give out.[/quote']
Agree with nursetim. And the samples.

allnurses Guide · Jan 5, 2013

Your lunch break is yours to do what you want with. I imagine you'd have to ask your boss if they have a problem with it.

nursetim, NP · Jan 5, 2013

Ask permission not to attend a detail lunch? Really? I'd just do what I'm going to do and have a discussion later if warranted. I go by the old saying, "it's easier to get forgiveness, than permission." That said I'm not you and you are not me. What works for you may not work for me and vice a versa.Employers in my experience will tell you if attendance is mandatory.

FlorenceNtheMachine · Jan 5, 2013

I think it would be fine to skip a few here and there, but my experience has been if the new person start skipping communal lunchtime, it comes off as antisocial. And it tends to make it harder for the new person to fit in. Just a thought!

annfaith, DNP, NP · Jan 5, 2013

When I was a new grad NP we had drug rep lunches daily as well. For me I took the opportunity to learn more indepth information about the drug. I still had the final decision on what medication was best for my patients, but the educational opportunity a couple of days a week could be beneficial. I often would review the research articles we were often given to compare products in or out of class. The doctors rarely ever went to the lunches and I was able to pick the ones that I felt were of an interest to me. Other times I would be in my office catching up on my charting. Reps were not allowed to come to our office so there was no explanation that was needed.

BlueDevil,DNP, DNP, RN · Jan 7, 2013

I never ate the free breakfasts or lunches, (we usually get both) and neither did the other providers. The only ones who did were the MAs and front office staff. The drug reps threatened to stop coming naturally, and I can't say that I blame them. They aren't coming to talk to the MAs, no matter how pretty they are, lol. We (the providers) discussed it and decided that the free lunches are a kind of "benefit" to the office staff that seemed unfair to take away from them. They don't make a lot of money comparatively speaking, and free breakfast or morning snack, plus free lunch and often an afternoon snack once or twice a week adds up to a benefit worth about $200 a month to them. Taking that away because we didn't want to be bothered seemed selfish, so we suck it up and take turns showing up enough to keep the goodies coming.

What we did do was request no junk food, no fast foods, no fried foods, and no desserts unless it is fresh fruit, and the reps have been very good about that. Lots of bottled water, salads, fruits and veggies. No soda, doughnuts, pizza, Chinese food, etc. When they realized that we really won't come unless they bring us (the providers) what we want to eat, they stuck to our preferred menu, lol. Some of the girls would much rather have pizza, in which case they can go out and buy their own. If they want a free meal, a healthy one is there for them at least 3 breakfasts and 4 lunch times a week. My favorite is the testosterone supplement guy because he always brings us smoothies from the local health food place (like Jamba Juice, but local mom & pop place)! I have never once prescribed his drug, but I'll come discuss it with him for 10 minutes a month if he keeps bringing me my nectar. I have no ethical qualms about this. He runs the data, he knowns I've never Rx'd his stuff. If I have a patient that needs/wants it, I might, but so far I haven't so them's the breaks. If he wants to spend $8 a month on me knowing I don't see very many eligible patients, that's his business.

I eat the salad the vaccine people bring too, and I give vaccines out daily as if they were, well, vaccines! lol. I'd vaccinate my patients even if they didn't bring me lettuce because I believe vaccinations are one of the most valuable tools of population health. However, I don't push vaccines on patients who don't want them just so I can earn extra croutons.

T-Bird78 · Jan 7, 2013

One of the MDs I worked for would listen to the updated spiel (which insurance was now accepting their drug as a tier 2 instead of tier 3, blah blah blah), grab his styrofoam box, say thanks, and go back to his desk. Eating a meal bought by a drug rep isn't an ethical dilemma--free Moe's burritos from one rep shouldn't deter you from writing a script for them or their competitor. If a free chicken sandwich makes you (or anyone) write a script for a drug that shouldn't be written, then there's more issues going on than we can tackle on this board. Just step in, say hello and that you have paperwork to take care of in your office, and give them a few minutes then leave. Lunch is your time and you are not obligated to the reps, but always get the samples! If there's a huge, major breakthrough then they will let you know or schedule an after-hours dinner outside the office for an educational session.